EASTSIDE THERAPY SERVICES (NPI# 1750846861) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750846861 |
| Entity Type | Organization |
| Organization Name | EASTSIDE THERAPY SERVICES |
| Practice Address |
33303 Se 124th St Issaquah WA 98027-8741 |
| Practice Telephone | 2067997831 |
| Mailing Telephone | 2067997831 |
| Enumeration Date | 2019-02-02 |
| Last Update Date | 2019-08-10 |
| Authorized Official Name | MRS. LAURA J FOWLS (BUSINESS OWNER, LEAD BEHAVIOR ANALY) |
| Authorized Official Telephone | 2067997831 |
| Authorized Official Credential | BCBA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 235Z00000X | Speech-Language Pathologist | Speech, Language and Hearing Service Providers | ||
| Y | 103K00000X | Behavioral Analyst | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NONE | NONE | 01 |
| Other Name | Type Code |
|---|---|
| Eastside Behavioral Consulting | Doing Business As Name - Organization |
| Street Address |
33303 SE 124TH ST |
| City | ISSAQUAH |
| State | WA |
| Zip Code | 98027-8741 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780281840 | Cascade Hand & Orthopedic Rehab, Inc. | Clinic/Center | 1301 4th Avenue Nw, Suite 200, Issaquah, WA 98027 | 2020-10-01 |
| 1700494630 | Genevieve S Ward | Counselor | 22500 Se 64th Place, Building G, Suite 150, Issaquah, WA 98027 | 2020-07-16 |
| 1891338604 | Amy Mezulis | Psychologist | 1740 Nw Maple St. #210, Issaquah, WA 98027 | 2019-10-24 |
| 1578055083 | Vivian Yu-en Hsiao | Physical Therapist | 1301 4th Ave Nw Ste 300, Issaquah, WA 98027 | 2018-05-31 |
| 1831698000 | Peter James Carlson | Physical Therapist | 22500 Se 64th Place, Building G, Suite 115, Issaquah, WA 98027 | 2018-02-02 |
| 1902323553 | David Robert Primrose | Dentist | 600 Nw Gilman Blvd Ste B, Issaquah, WA 98027 | 2017-08-24 |
| 1083135446 | Tara Rose | Massage Therapist | 680 Nw Gilman Blvd., Ste. A, Issaquah, WA 98027 | 2017-07-06 |
| 1295276194 | Amy Davenport | Occupational Therapist | 1871 Nw Gilman Blvd #2, Issaquah, WA 98027 | 2017-03-13 |
| 1942751771 | Krista L Gibbons | Counselor | 1700 Nw Blvd, Suite #200, Issaquah, WA 98027 | 2016-10-17 |
| 1376903237 | Kari Wathen Torres | Occupational Therapist | 710 Nw Juniper St Ste 100, Issaquah, WA 98027 | 2016-03-03 |
| Find all providers in zip 98027 | ||||
| Taxonomy Code | 103K00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Behavioral Analyst |
| A behavior analyst is qualified by at least a master’s degree and Behavior Analyst Certification Board certification and/or a state-issued credential (such as a license) to practice behavior analysis independently. Behavior analysts provide the required supervision to assistant behavior analysts and behavior technicians. A behavior analyst delivers services consistent with the dimensions of applied behavior analysis. Common services may include, but are not limited to, conducting behavioral assessments, analyzing data, writing and revising behavior-analytic treatment plans, training others to implement components of treatment plans, and overseeing implementation of treatment plans. |
| Notes: Source: Association of Professional Behavior Analysts, www.apbahome.net and Behavior Analyst Certification Board (http://www.bacb.com) [7/1/2008: new, 1/1/2016: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902410327 | Michele Sevart | Behavioral Analyst | 590 Timber Creek Dr Nw, Issaquah, WA 98027-5650 | 2020-09-02 |
| 1083189187 | Jenean Rene Creason | Behavioral Analyst | 1420 Nw Gilman Blvd # 2604, Issaquah, WA 98027-5394 | 2018-10-04 |
| 1487136370 | Caila Fautenberry | Behavioral Analyst | 1420 Nw Gilman Blvd Ste 2604, Issaquah, WA 98027-5394 | 2018-09-06 |
| 1679982847 | Kelly Alice Pipe-campbell | Behavioral Analyst | 1083 Sw Mt Markham Pl, Issaquah, WA 98027-3502 | 2014-08-12 |
| 1508111766 | Penny Jane Lathum | Behavioral Analyst | 3849 Klahanie Dr Se Apt 1-101, Issaquah, WA 98029-5720 | 2012-07-13 |
| 1629362173 | Christen A Rae | Behavioral Analyst | 350 Se Andrews St, Issaquah, WA 98027-3413 | 2011-06-01 |
| 1497056766 | Eileen Chew | Behavioral Analyst | 2328 Ne Park Dr, Issaquah, WA 98029-7401 | 2010-11-03 |
| 1942850672 | Christine A Warner | Behavioral Analyst | 5410 194th Ave Se, Issaquah, WA 98027-8626 | 2019-09-15 |
| 1841858008 | Kai Lee | Behavioral Analyst | 5410 194th Ave Se, Issaquah, WA 98027-8626 | 2019-06-03 |
| 1962976639 | Christine Hartle | Behavioral Analyst | 1420 Nw Gilman Blvd # 2604, Issaquah, WA 98027-5394 | 2019-01-16 |
| Find all providers in ISSAQUAH | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.